【摘要】：前言 科學(xué)研究已從不同角度證明了吸煙是肺癌、慢性呼吸系統(tǒng)疾病、冠心病、腦卒中等多種疾病發(fā)生和死亡的重要危險(xiǎn)因素。目前全球有11億吸煙者,每年近500萬(wàn)人死于煙草相關(guān)疾病。我國(guó)煙草生產(chǎn)和消費(fèi)各占全球的1/3以上;15-69歲的吸煙人數(shù)達(dá)3.5億;每年死于煙草相關(guān)疾病的人數(shù)近100萬(wàn),占全部死亡人數(shù)的12%。英國(guó)著名流行病學(xué)家理查德皮托教授預(yù)測(cè):若中國(guó)當(dāng)前的吸煙形勢(shì)得不到有效控制,到2025年中國(guó)每年死于煙草相關(guān)疾病的人數(shù)將達(dá)200萬(wàn);現(xiàn)在的兒童中,屆時(shí)將有2億人躋身煙民的行列,其中5000萬(wàn)人將死于吸煙引起的疾病。 吸煙者戒煙是21世紀(jì)中葉以前減少吸煙相關(guān)死亡的最有效途徑。但根據(jù)1984年全國(guó)50萬(wàn)15歲以上人群隨機(jī)抽樣調(diào)查結(jié)果表明:我國(guó)男性吸煙者戒煙率僅為4.17%,女性為9.73%,男女平均戒煙率為4.78%;戒煙原因68.37%是由于本人患病。1996年全國(guó)吸煙行為流行病學(xué)調(diào)查結(jié)果顯示:僅有16.8%吸煙者打算戒煙,但實(shí)際戒煙者僅占吸煙者的9.4%,且成功率僅占吸煙者的3.6%。吸煙者戒煙的主要原因是已患吸煙有關(guān)疾病而被迫戒煙。因此,制定行之有效的控?zé)熃錈煷胧┛滩蝗菥彙Ｈ欢壳?國(guó)內(nèi)外對(duì)戒煙過(guò)程的行為學(xué)特征及其影響因素研究甚少,從而制約了有效戒煙措施的制定。 國(guó)內(nèi)外的流行病學(xué)調(diào)查顯示:吸煙習(xí)慣的養(yǎng)成主要是在青少年時(shí)期,可見(jiàn)青少年吸煙問(wèn)題是中國(guó)吸煙問(wèn)題的關(guān)鍵所在。因?yàn)榍嗌倌暾幵谏L(zhǎng)發(fā)育時(shí)期,吸煙對(duì)正常生長(zhǎng)發(fā)育會(huì)造成損害。因此,讓青少年遠(yuǎn)離煙草是每個(gè)國(guó)家義不容辭的責(zé)任和義務(wù)。 被動(dòng)吸煙的受害人群也不容忽視,2007年《中國(guó)煙草控制報(bào)告》指出,中國(guó)有5.4億非吸煙者(其中包括1.8億名15歲以下的兒童)正在遭受二手煙所帶來(lái)的危害,而且這種現(xiàn)象在娛樂(lè)場(chǎng)所更為嚴(yán)重。 中國(guó)煙草消費(fèi)及煙草相關(guān)疾病所導(dǎo)致的沉重負(fù)擔(dān),使煙草控制成為一個(gè)亟需解決的公共衛(wèi)生問(wèn)題。 目的 通過(guò)對(duì)“中國(guó)《煙草控制框架公約》監(jiān)測(cè)”沈陽(yáng)市基線調(diào)查數(shù)據(jù)的分析,來(lái)了解沈陽(yáng)市吸煙人群中有戒煙意愿者的人口學(xué)特征及其影響因素,為有關(guān)部門(mén)制定有效的戒煙控?zé)煷胧┨峁┛茖W(xué)依據(jù);通過(guò)對(duì)沈陽(yáng)市大中學(xué)生吸煙行為及相關(guān)影響因素的調(diào)查分析,來(lái)掌握沈陽(yáng)市大中學(xué)生的吸煙狀況,探討影響其吸煙行為的相關(guān)因素,為開(kāi)展學(xué)生控?zé)熖峁┮罁?jù);以出入娛樂(lè)場(chǎng)所的吸煙者為研究對(duì)象,來(lái)探索娛樂(lè)場(chǎng)所吸煙行為的相關(guān)因素,為制定適合我國(guó)娛樂(lè)場(chǎng)所具體情況的綜合性控?zé)熣咛峁┮罁?jù)。 研究方法 沈陽(yáng)市成年吸煙者戒煙意愿調(diào)查及影響因素分析:2006年4月-10月,在沈陽(yáng)市內(nèi)五個(gè)區(qū)(和平區(qū)、皇姑區(qū)、沈河區(qū)、鐵西區(qū)和大東區(qū)),采用多階段分層隨機(jī)整群抽樣的方法,按照“街道→社區(qū)→家庭→調(diào)查對(duì)象”四個(gè)階段進(jìn)行抽樣。其中,第一階段使用按容量比例概率抽樣法(PPS)抽取10個(gè)街道;第二階段使用按容量比例概率抽樣法(PPS)在每個(gè)街道抽取2個(gè)社區(qū);第三階段使用簡(jiǎn)單隨機(jī)抽樣法在每個(gè)社區(qū)抽取300戶(hù)家庭并進(jìn)行家庭成員信息登記;第四階段使用簡(jiǎn)單隨機(jī)抽樣法在300戶(hù)家庭中抽取60個(gè)家庭(先調(diào)查40個(gè)家庭,剩余20個(gè)家庭備用)。抽中的家庭如果只有1名成年吸煙者則為調(diào)查對(duì)象;如果有1名以上成年吸煙者,則選擇1個(gè)生日距離調(diào)查日期最近的為調(diào)查對(duì)象;若沒(méi)有成年吸煙者,采用簡(jiǎn)單隨機(jī)抽樣方法從備用戶(hù)中抽取1戶(hù)置換;每個(gè)居委會(huì)至少調(diào)查40名吸煙者(每戶(hù)家庭調(diào)查吸煙者數(shù)不超過(guò)1個(gè));最終在沈陽(yáng)市抽取調(diào)查了801名成年吸煙者。調(diào)查對(duì)象納入標(biāo)準(zhǔn)為:年齡≥18周歲;沈陽(yáng)市常住居民(戶(hù)口和日常生活均在沈陽(yáng)市內(nèi)五區(qū));至抽樣之日時(shí),已經(jīng)吸煙≥100支,并且現(xiàn)在仍然吸煙的人。吸煙定義:至抽樣之日,已經(jīng)吸煙≥100支,并且現(xiàn)在仍然吸煙者;有戒煙意愿者定義:吸煙人群中現(xiàn)在仍吸煙,但在未來(lái)一年內(nèi)有戒煙打算者。 沈陽(yáng)市大中學(xué)生吸煙行為現(xiàn)狀調(diào)查及影響因素分析:于2005年11月-2006年5月,采取分層隨機(jī)整群抽樣的方法,分別確定了1855名中學(xué)生和1117名大學(xué)生作為調(diào)查對(duì)象;由經(jīng)過(guò)統(tǒng)一培訓(xùn)的調(diào)查員,采用自制封閉式問(wèn)卷為調(diào)查表,以班級(jí)為單位進(jìn)行調(diào)查;調(diào)查表以不記名的方式由調(diào)查員在教室發(fā)給學(xué)生,由調(diào)查員講解調(diào)查目的和問(wèn)卷的填寫(xiě)方式后,學(xué)生在教室當(dāng)場(chǎng)填寫(xiě),統(tǒng)一答卷,并當(dāng)場(chǎng)收回。吸煙定義:指包括嘗試吸煙(曾經(jīng)嘗試過(guò)吸煙,即使只吸過(guò)一兩口的行為)和現(xiàn)在吸煙(在過(guò)去30天,吸過(guò)完整一支煙的行為)在內(nèi)的所有情況。 吸煙者在室內(nèi)娛樂(lè)場(chǎng)所吸煙行為調(diào)查及影響因素分析:該研究的數(shù)據(jù)來(lái)自中國(guó)《煙草控制框架公約》監(jiān)測(cè)調(diào)查的基線數(shù)據(jù)。我國(guó)ITC基線調(diào)查現(xiàn)場(chǎng)工作于2006年4月到10月在沈陽(yáng)開(kāi)展。北京、上海、長(zhǎng)沙、廣州、銀川等城市也同時(shí)開(kāi)展。每個(gè)城市采用多階段抽樣法,按照“街道→社區(qū)→家庭→調(diào)查對(duì)象”四個(gè)階段進(jìn)行抽樣。其中,第一階段使用按容量比例概率抽樣法(PPS)在每個(gè)城市抽取10個(gè)街道;第二階段再次使用按容量比例概率抽樣法(PPS)在每個(gè)街道抽取2個(gè)社區(qū);第三階段使用簡(jiǎn)單隨機(jī)抽樣法在每個(gè)社區(qū)抽取300戶(hù)家庭并進(jìn)行家庭成員信息登記;第四階段使用簡(jiǎn)單隨機(jī)抽樣法在300戶(hù)家庭中抽取約40名吸煙者(每戶(hù)家庭調(diào)查吸煙者數(shù)不超過(guò)1個(gè))。最終在每個(gè)城市抽取至少800名成年吸煙者。調(diào)查對(duì)象納入標(biāo)準(zhǔn)為:年齡≥18歲,本市常住居民(戶(hù)口和日常生活均在本市的居民);至抽樣之日,已經(jīng)吸煙≥100支煙,并且現(xiàn)在仍然吸煙者。 主要研究結(jié)果 沈陽(yáng)市吸煙者中有戒煙意愿者的比例為30.7%;男性有戒煙意愿者的比例(29.8%)遠(yuǎn)低于女性(46.7%);職業(yè)分布中,以國(guó)家機(jī)關(guān)黨群組織負(fù)責(zé)人中有戒煙意愿的比例最高達(dá)47.5%,其次為離退休人員36.7%,以專(zhuān)業(yè)技術(shù)人員有戒煙意愿的比例最低為21.4%。影響因素分析發(fā)現(xiàn):親人反對(duì)、社會(huì)輿論、對(duì)健康的影響、控?zé)熜麄鞯牧Χ取⒔】稻拘畔⒌钠占�、�?duì)煙草相關(guān)疾病的知曉程度以及對(duì)戒煙產(chǎn)品和戒煙服務(wù)的接觸均會(huì)影響吸煙者戒煙意愿的產(chǎn)生。 沈陽(yáng)市大中學(xué)生的嘗試吸煙率為34.6%,男女生分別為46.9%和21.2%,男生顯著高于女生;現(xiàn)在吸煙率為11.3%,男女生分別為18.5%和3.4%。影響因素分析發(fā)現(xiàn):處身于吸煙的環(huán)境(同吸煙者在一起)、不知道如何拒絕別人遞煙的禮節(jié)、傷心壓抑的心情均是促進(jìn)學(xué)生吸煙習(xí)慣形成的重要因素;而幫助學(xué)生提高學(xué)習(xí)成績(jī)、正確認(rèn)識(shí)煙草的危害可以很好地預(yù)防學(xué)生吸煙習(xí)慣的形成。 全國(guó)六城市吸煙人群的調(diào)查結(jié)果顯示:高達(dá)83.6%的吸煙者在光顧室內(nèi)娛樂(lè)場(chǎng)所時(shí)都曾有過(guò)吸煙行為(男性:84.0%,女性:70.1%);地區(qū)分布以沈陽(yáng)和上海最高分別為87.7%和87.1%,以北京最低僅75.4%。影響因素分析發(fā)現(xiàn):室內(nèi)娛樂(lè)場(chǎng)所禁煙規(guī)定實(shí)施不力或者無(wú)禁煙法規(guī)、吸煙者對(duì)室內(nèi)娛樂(lè)場(chǎng)所控?zé)煹膽B(tài)度、對(duì)煙草相關(guān)疾病的知曉程度、周?chē)巳旱挠绊憽?duì)吸煙行為的態(tài)度是影響吸煙者在室內(nèi)娛樂(lè)場(chǎng)所吸煙行為的主要因素。 結(jié)論 沈陽(yáng)市吸煙人群中有戒煙意愿者的比例低于國(guó)內(nèi)同級(jí)城市,煙草相關(guān)疾病的知曉程度偏低。通過(guò)普及煙草危害的健康教育、提倡親人積極參與吸煙者的戒煙活動(dòng)、豐富煙草包裝健康警示信息內(nèi)容、提高控?zé)熜麄鞯牧Χ纫约巴茝V戒煙產(chǎn)品和戒煙服務(wù)等措施可以很好地提高沈陽(yáng)市吸煙者戒煙意愿的產(chǎn)生。 沈陽(yáng)市大中學(xué)生的嘗試吸煙率,無(wú)論男生還是女生,均高于全國(guó)平均水平;現(xiàn)在吸煙率與全國(guó)平均水平相一致。通過(guò)營(yíng)造大學(xué)生和中學(xué)生生活的無(wú)煙環(huán)境、提高其拒絕別人遞煙的技巧、緩解其傷心壓抑的心情、幫助學(xué)生提高學(xué)習(xí)成績(jī)、正確認(rèn)識(shí)吸煙對(duì)健康的危害,可以很好地預(yù)防青少年學(xué)生吸煙習(xí)慣的形成。 加強(qiáng)室內(nèi)娛樂(lè)場(chǎng)所控?zé)煼ㄒ?guī)的實(shí)施力度是控制室內(nèi)娛樂(lè)場(chǎng)所吸煙行為和二手煙暴露的關(guān)鍵環(huán)節(jié);提高吸煙者煙草相關(guān)疾病的知曉程度是控?zé)煿ぷ魅〉贸尚У挠行Т胧┖透颈ＷC。
[Abstract]:Preface
Scientific research has proved that smoking is an important risk factor for the occurrence and death of various diseases such as lung cancer, chronic respiratory system disease, coronary heart disease and stroke. There are 1 billion 100 million smokers worldwide and nearly 5 million people die of tobacco related diseases each year. The production and consumption of tobacco in our country are more than 1/3 in the world; the number of smokers at 15-69 years old Up to 350 million; Professor Richard Peto, a famous British epidemiologist who dies of tobacco related diseases every year, and accounts for all deaths, predicts that if the current smoking situation in China is not effectively controlled, the number of people dying of tobacco related diseases per year will reach 2 million by 2025, and there will be 200 million of these children in 2025. People join the ranks of smokers. 50 million of them will die from diseases caused by smoking.
Smoking cessation is the most effective way to reduce smoking related deaths before the middle of the mid twenty-first Century. But according to the national random sampling survey of people over 500 thousand and 15 years of age in 1984, the smoking cessation rate of male smokers in China is only 4.17%, women are 9.73%, the average rate of smoking cessation is 4.78% for men and women, and the reason for smoking abstinence is 68.37% because of the national.1996 year of illness. The epidemiological survey of smoking behavior showed that only 16.8% smokers intended to quit smoking, but the actual smoking cessation only accounted for 9.4% of the smokers, and the success rate only accounted for the smokers' 3.6%. smokers, the main reason was that they had been forced to quit smoking related diseases. Therefore, it is urgent to establish effective measures for smoking and smoking cessation. However, the current state of smoking and smoking cessation is urgent. There are few studies on behavioral characteristics and influencing factors of smoking cessation process, which restricts the formulation of effective smoking cessation measures.
Epidemiological surveys at home and abroad show that smoking habits are mainly in youth, and that smoking in adolescents is the key to the problem of smoking in China. Because young people are in a growing period, smoking will cause damage to normal growth and development. Therefore, it is incumbent on every country to keep young people away from tobacco. Responsibility and obligation.
The victims of passive smoking should not be ignored. In 2007, the China tobacco control report noted that 540 million non smokers in China (including 180 million children under 15 years of age) are suffering from second-hand smoke, and this phenomenon is more serious in entertainment places.
The heavy burden caused by tobacco consumption and tobacco related diseases in China has made tobacco control an urgent public health problem.
objective
Through the analysis of the Shenyang baseline survey data of the "China Framework Convention on tobacco control", the demographic characteristics and influencing factors of smokers with smoking cessation in Shenyang are understood and the scientific basis for the relevant departments to formulate effective measures for smoking cessation and tobacco control is provided; and the smoking behavior and related shadow of the middle school students in Shenyang are given. The investigation and analysis of the noise factors to master the smoking status of the middle school students in Shenyang and discuss the related factors affecting their smoking behavior, provide the basis for carrying out the students' smoking control, and explore the related factors of smoking behavior in the entertainment places by taking the smokers in the entertainment places as the research object, so as to make a comprehensive summary of the specific circumstances of the entertainment places in our country. The policy of combining tobacco control provides the basis.
research method
The survey of smoking cessation willingness of adult smokers in Shenyang and analysis of its influencing factors: in April 2006 -10 month, in the five districts of Shenyang (peace zone, Huanggu District, Shenhe District, Tiexi district and Dadong District), multi stage stratified random cluster sampling was adopted to sample the four stages of "street, community, family and investigation object". At the stage, 10 streets were extracted by the probability sampling method of capacity ratio (PPS); the second stage uses the capacity proportional probability sampling (PPS) to extract 2 communities in each street; the third stage uses a simple random sampling method to extract 300 households in each community and register the family member information; the fourth stage uses a simple random sampling method at 3. 60 families were selected from 00 families (first 40 families and 20 remaining families). If only 1 adult smokers were selected, there were more than 1 adult smokers, and 1 Birthday distances were selected for the latest survey date; and if no adult smokers, a simple random sampling method was used. At least 40 smokers were investigated (no more than 1 smokers per household), and 801 adult smokers were investigated in Shenyang. The standard of the survey was: age more than 18 years old; Shenyang resident (registered permanent residence and daily life in five districts in Shenyang); to sample. At the time of the day, smokers who have smoked more than 100 and are still smoking. Definition of smoking: smoking more than 100 cigarettes at the date of sampling, and still smokers; the definition of the will of smoking cessation: smoking is still smoking in the population, but there is a smoking cessation in the coming year.
The investigation and analysis of the influencing factors of smoking behavior in Shenyang middle school students: in May -2006 November 2005, 1855 middle school students and 1117 college students were selected as the investigation object by stratified random cluster sampling. The questionnaire was issued by investigators in the classroom by investigators in the anonymous way. After the investigators explained the purpose of the investigation and the filling out of the questionnaire, the students filled in the classroom on the spot, unified the answer, and returned it on the spot. All the situations in the past 30 days, which had smoked a complete cigarette.
Smokers' smoking behavior in indoor entertainment and influencing factors analysis: the data of this study came from the baseline data of the China Framework Convention on tobacco control. The ITC baseline survey in China was carried out in Shenyang from April 2006 to October. Beijing, Shanghai, Changsha, Guangzhou, Yinchuan and other cities were also carried out at the same time. Multi stage sampling is used to sample the four stages of "street, community, family, and investigation object". In the first stage, 10 streets are extracted in each city by the probability sampling method of capacity ratio (PPS); the second stage is again using the capacity ratio probability sampling (PPS) to extract 2 communities in each street; the third stage is made. A simple random sampling method was used to select 300 households in each community and to register family members. The fourth stage used a simple random sampling method to extract about 40 smokers in 300 households (no more than 1 smokers per household survey). In the end, a total of 800 adult smokers were selected in each city. The subjects were included in the standard. Over 18 years of age, permanent residents in this city (household and daily life are residents in this city); on the day of sampling, they smoked more than 100 cigarettes and are still smokers.
Main research results
The proportion of smokers who had the will of smoking cessation in Shenyang was 30.7%, the proportion of the men who had the will of smoking cessation (29.8%) was far lower than that of the women (46.7%). In the occupational distribution, the proportion of the willingness to quit smoking was up to 47.5%, followed by 36.7% of the retirees, and the lowest rate of smoking cessation by professional and technical personnel was 2. The analysis of the influencing factors of 1.4%. found that the opposition of relatives, public opinion, the impact on health, the intensity of tobacco control, the popularity of health warning information, the awareness of tobacco related diseases and the contact of smoking cessation products and smoking cessation services will affect the smoking cessation intention of smokers.
The smoking rate of Shenyang middle school students was 34.6%, the male and female students were 46.9% and 21.2% respectively. The male students were significantly higher than the female students. The smoking rate was 11.3%. The factors of the male and female students were 18.5% and 3.4%., respectively. It is an important factor to promote the formation of students' smoking habits, and helping students to improve their learning performance and correctly understand the harm of tobacco can well prevent the formation of students' smoking habits.
The survey of smokers in six cities in six cities showed that up to 83.6% smokers had smoked in indoor entertainment places (male: 84%, women: 70.1%), the highest in Shenyang and Shanghai was 87.7% and 87.1%, and the analysis of the lowest 75.4%. factors in Beijing found that smoking regulation in indoor entertainment places was implemented. The attitude of smokers to smoke control in indoor entertainment, the degree of awareness of tobacco related diseases, the influence of the surrounding population, and the attitude to smoking behavior are the main factors affecting smokers' smoking behavior in indoor entertainment.
conclusion
The proportion of smoking cessation willing among smokers in Shenyang is lower than that in domestic cities, and the awareness of tobacco related diseases is low. By popularizing the health education of tobacco harm, it is necessary to encourage relatives to actively participate in smoking cessation activities, enrich the information content of tobacco packaging health warning, improve the intensity of tobacco control and promote the product of smoking cessation. And smoking cessation services can improve the smoking cessation intention of smokers in Shenyang.
The smoking rate of Shenyang middle school students, both male and female, is higher than the national average. Now the smoking rate is in line with the national average. By building the smokeless environment of college students and middle school students, they can improve their skills of refusing other people's smoking and relieve their depressed mood and help students to improve their academic performance. Knowing the harm of smoking to health can prevent the formation of smoking habits among young students.
Strengthening the enforcement of tobacco control regulations in indoor entertainment places is the key link in controlling smoking and second-hand smoke exposure in indoor entertainment places, and improving the awareness of tobacco related tobacco related diseases is an effective measure and fundamental guarantee for the effectiveness of tobacco control.
【學(xué)位授予單位】：中國(guó)醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2009
【分類(lèi)號(hào)】：R181.3

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 王海霞;我國(guó)禁煙公益廣告的問(wèn)題及對(duì)策研究[D];華中師范大學(xué);2011年

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本文編號(hào)：2137654